HomeMy WebLinkAboutHomestead_Dunlap -^ ,A • STATE FORM 53569(UI&WO TREASLPFA FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.3000 PRESCRIBED BY THE DEPARTMENT OF LOYAL GOVERNMENT FINANCE mbl.I.214.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS •
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud Homestead fraud causes higher tax bills for all;therefore,
HFA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
FILED '
L E benefit and to provide additional ept coning information necessary to allow county government to better monitor homestead
' 1 filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud
PART I: PROPERTY INFORMATION
MAY 2 ZUII Taxpayer Name Location Address
C.3.rn. Hyneman, Carol J/Jennifer L Dunlap
106E Vine ST
GIBSON COUNTY AUDITOR FORT BRANCH IN 47648
2160 1
Jennifer LDunlap 11010111_um[II 101110111.011 I1011_l!DIIl11�lfliiiii Dilill 1100!l1[111lol
106E Vine St
FORT BRANCH IN 47648-1116 -
IIIIIIIIIIIIII'IIItI1"IIlliIItIIIItIIIIII'II'iiIllll ttltllltl State Parcel Number Legal Description
— — — 26_1813404-000.429-026 /GENUNG&WAITERS m
This form MUST be returned to County Auditor's office. -
Please do NOT send this form back with your tax payment to the county treasurer.
r PART 2: TAXPAYER INFORMATION
II 1 First Middle Last
Jenni r L MtAnlq
Mailing Address(number and street,city,state,and ZIP code) - flame as property address .
I 0 6 & vine,
.
Spouse First Middle - Last
Mailing-Amiress Number and street;ci - - - - - - - -
g ( ty,state,and21P untie) - _ �'Same as'propcity address - - - -_
Social Security Number(last 5 digits) ' Driver's License/State ID Number (last 5 digits) ' Other(please specify in Part 4 below)
I I I I 1 I 1 1 1 sty
. PART 3: CERTIFICATION . •
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property.Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she maybe liable for back taxes and substantial financial penalties. -
Owner 1 Signature Date [-
-
PART 4: ADDITIONAL INFORMATION
rn CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
am_ '_, STANDARD /SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R13/12-09) HC 10
„„� Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for Ong instructions. ,, ,�
ell If` . !r CERTIFICATICN'STAIEEMMENT II If (k,; i(t,/oU(U _ -
I(We) r1 a1_31� '-E'Jl U I certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the folio 'ft g described real property for I ich a Homej j'ad Property Tax Standard Deduction is hereby claimed
under contract on the date this application is filed, (date of filing). I(We): FILED
❑ Own El Am(are)buying under recorded contract
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified persiMilAfe9denntigst
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
-l `- e 77 -
Name ofcl -nt egalname)
Social Security number of claimant's spouse(last live digits)(Drivers license/Identification/Other number Issuing State
of claimant's spouse(last five digits)
•
_ ;CONTRACT_RECORDED: .-If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number Page
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I
. _-, .@ -..�_: ' ' _PROPERTY DESCRIPTION X11 .
Coun , Township Taxing district( ,, . ship) _ n
&4 $ s. . S ><
P I number �y1 �/�Lfegal description Is,,,,the���property in question:
[7^'�000 4029-0 c K IKeal property ❑ Annually assessed mobile home(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately sun-cu ds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
PROPERTY_OWNED By CLAIMANT IN OTHER COUNTIES, -
County Township County Tow/nsship�//J�.�/.//� .r
S. a u -o/daiman
I hereby certify the above statements are true,correct and complete. ---//f-(----JJJ,
Address Iefac sue' • , ate,and ZIP me / cur`-CA--' • ^ , 7� ,!�
ASSESSOR USE ONLY • - I TRUE TAX VALUE`01 AAASSES %OFT,TV I-C({H-OVALUEAD I , NON-RESIDENTIAL
Land not exceeding 1(one)acre immediately
surrounding residential improvements. (1)
Other land (2)
•
Total land(line 1 plus line 2) (3)
Dwelling (4)' `
Residential improvements or Annually
Assessed Mobile I Manufactured Home Garage (5)
Other improvements (6)
Total Improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
I and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
' STANDARD DEDUCTION ALLOWANCE 20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.7-12 to a mobile home that is $
not arse •ed as real property or to a manufactured home that is not assessed as real property may not exceed
one-half . of the assessed vat -of the mobile A e or manufactured home.
Signature d/ •itor / Date signed(month,day,year)
4 1r 1
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